320排CT双能量成像技术评估痛风性关节炎的临床应用研究

Clinical Application of 320-slice CT Dual-energy Imaging in Evaluating Gouty Arthritis

目的:分析320排CT双能量成像技术对痛风性关节炎的诊断价值。方法:选取2019年1月-2020年2月因外周关节疼痛于本院就诊的患者80例,根据临床诊断分为试验组(痛风)50例与对照组(非痛风)30例。所有患者均采用320排CT行双能量CT(DECT)检查,观察两组患者的影像特征,比较两组患者的血尿酸、血沉和C反应蛋白(CRP),分析DECT检测尿酸盐结晶(MSU)的敏感度、特异度、阳性预测值、阴性预测值、诊断符合率。结果:两组性别、年龄、血沉、CRP比较,差异均无统计学意义(P>0.05);试验组血尿酸(SUA)高于对照组,差异有统计学意义(P<0.001)。DECT检测MSU的敏感度为84.0%、特异度为86.7%、阳性预测值为91.3%、阴性预测值为76.5%,诊断符合率为85.0%。试验组MSU结晶阳性率高于对照组,差异有统计学意义(X^2=38.315,P<0.001)。结论:320排CT双能量成像技术能清晰显示MSU结晶沉积部位、分布、临近骨质破坏程度,对尿酸盐结晶的检出具有较高的敏感度、特异度和可靠性,且安全、无创,对于痛风性关节炎诊断具有重要价值。

Objective:To analyze the diagnostic value of 320-slice CT dual-energy imaging technology in gouty arthritis.Method:A total of 80 patients who presented to our hospital for peripheral joint pain from January 2019 to February 2020 were selected,they were divided into 50 cases in the experimental group(gout)and 30 cases in the control group(non-gout)according to clinical diagnosis.All patients were examined with 320-slice CT for dual-energy CT(DECT),the imaging characteristics of patients in the two groups were observed,and the serum uric acid erythrocyte sedimentation rate and C-reactive protein(CRP)in the two groups were compared.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic coincidence rate of urate crystal(MSU)detected by DECT were analyzed.Result:There were no significant differences in gender,age,ESR,and CRP between the two groups(P>0.05);serum uric acid(SUA)in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.001).The sensitivity,specificity,positive predictive value and negative predictive value of MSU were 84.0%,86.7%,91.3%and 76.5%respectively,and the diagnostic coincidence rate was 85.0%.The positive rate of MSU crystallization in the experimental group was higher than that in the control group,the difference was statistically significant(x^2=38.315,P<0.001).Conclusion:The 320-slice CT dual-energy imaging technology can clearly show the deposition location,distribution,and degree of bone destruction near MSU crystals,it has high sensitivity,specificity and reliability for the detection of urate crystals,and is safe and non-invasive,the diagnosis of gouty arthritis is of great value.